Lesson 1Clinical resources and evidence summaries from professional bodies (recommendations for REM use)This lesson sums up guidelines from AAA, ASHA, BSA, and other key bodies on verification practices. It stresses the proof for real-ear measurement (REM), suggested steps, record-keeping, and weaving best practices into your daily clinic routine.
Key AAA and ASHA REM recommendationsBSA and international REM guidanceEvidence comparing REM to first-fitBarriers to guideline implementationCommunicating best practice to patientsLesson 2Compression basics: attack/release times, number of channels, kneepoints, wide dynamic range compression rationaleHere we break down compression aims and settings, covering attack and release times, channel count, and kneepoints. We discuss wide dynamic range compression, speech clarity, and how tweaks impact comfort, avoid distortion, and support verification.
Goals of compression in hearing aidsAttack and release time trade-offsNumber of channels and fine-tuningKneepoints and compression ratiosWDRC and speech audibility benefitsLesson 3Functional verification: aided speech-in-noise testing (QuickSIN, HINT), aided warble-tone thresholds, aided soundfield testingThis focuses on practical verification with aided soundfield tests. We review QuickSIN, HINT, warble-tone thresholds, and reading results with REM to inform counselling and adjustments.
Aided soundfield warble-tone thresholdsQuickSIN setup and score interpretationUsing HINT and similar speech testsRelating functional tests to REM dataCounseling patients using test resultsLesson 4REM protocols: aided response, speech mapping, measurement conditions (soft, conversational, loud inputs) and corrections for SPL vs dB HLWe detail REM steps for aided responses and speech mapping. It includes test signals, input levels, conditions, and shifts between SPL and dB HL for spot-on, comparable verification outcomes.
Selecting test signals and stimuliSoft, conversational, and loud inputsAided response vs insertion gain viewsCorrections between SPL and dB HLManaging test–retest variabilityLesson 5Documentation and reporting for verification: recording REAR/REIG, target deviations and clinical decision rulesThis outlines top practices for verification records, with REAR and REIG graphs, target gaps, and clinical logic. It stresses clear reports for legal needs, follow-ups, and team chats.
Recording REAR and REIG measurementsDefining acceptable target deviationsNoting MPO and loudness outcomesWriting clear clinical justificationsReporting for referrals and insurersLesson 6Real-ear verification (REM) fundamentals: probe placement, calibration, typical target curves and interpretationIntro to REM basics, gear, and setup. Covers probe tube fitting, reference mic use, and making sense of target curves like REAR, REIG, and speech maps in clinic software.
REM equipment and signal typesCorrect probe tube placement techniquesCalibration and reference mic controlUnderstanding REAR, REIG, and RECDReading and interpreting target curvesLesson 7Fitting formulas: DSL v5 — principles, pediatric origin, use for severe losses and loudness managementDive into DSL v5 background, kids-first design, and loudness balancing. Covers who it's for, target setup, severe loss handling, focusing on comfort, hearing range, and daily checks.
Historical development and pediatric rationaleLoudness normalization vs equalization conceptsDSL v5 targets for severe and profound lossesManaging loudness discomfort and safetyVerification of DSL fittings with REMLesson 8Maximum power output (MPO) and output limiting strategies for loudness and safetyCovers MPO ideas, checks, and tweaks. Reviews limiting with compression or clipping, weighing hearing range, sound quality, safety against discomfort and ear damage over time.
Defining MPO and its clinical relevanceMeasuring MPO in coupler and real earCompression limiting vs peak clippingSetting MPO for comfort and safetySpecial MPO issues in pediatric fittingsLesson 9Overview of hearing aid styles and form factors (BTE, RIC, ITE, CIC, RITE) and clinical implicationsLooks at main hearing aid types like BTE, RIC, ITE, CIC, RITE. Checks looks, sound, handling, plus fit for hand skills, ear shape, and loss level.
BTE and thin-tube fittingsRIC and RITE design considerationsITE, ITC, and CIC custom devicesOpen vs occluded fittings and ventingStyle selection based on patient needsLesson 10Common manufacturer fitting software features that affect verification (real-ear simulated targets, coupler-based presets) and limitationsReviews how maker software makes simulated real-ear targets and coupler presets. Covers assumptions, age and vent effects, and need for own REM to confirm personal fits.
First-fit algorithms and default presetsReal-ear simulated targets in softwareCoupler-based fittings and assumptionsImpact of venting and acoustic couplingWhy REM is needed beyond softwareLesson 11Technical classifications: analogue vs digital, receiver-in-canal vs receiver-in-ear, programmable featuresSorts aids by processing and shape. Explains analogue vs digital, RIC vs RITE terms, and key tweaks for fitting ease, checks, and patient results.
Analog vs digital processing basicsBTE, RIC, RITE, ITE, CIC distinctionsTelecoil, wireless, and streaming optionsDirectional microphones and noise reductionData logging and adaptive featuresLesson 12Fitting formulas: NAL-NL1/NL2 — principles, targets, strengths for speech intelligibilityCovers NAL-NL1/NL2 growth, aims, targets. Stresses speech understanding boost, loudness match, and picking between them for adults and special groups.
Historical development of NAL formulasSpeech intelligibility and loudness goalsDifferences between NAL-NL1 and NAL-NL2Selecting NAL vs DSL for adultsVerifying NAL fittings with REM
